Assessing Feasibility and Readiness to Address Obesity through Policy in American Indian Reservations

The Institute of Medicine and Centers for Disease Control and Prevention (CDC) have identified policy and environmental strategies as critical to the prevention and control of obesity. However such strategies are rare in American Indian communities despite significant obesity-related disparities. Tribal policymaking processes differ by tribal nation and are often poorly understood by researchers and public health practitioners, hindering the dissemination, implementation, and successful scale-up of evidence-base obesity strategies in tribal communities. To address these gaps in knowledge we surveyed 138 diverse stakeholders in two American Indian reservations to assess the feasibility of and readiness to implement CDC-recommended obesity policy strategies within their communities. We assessed general community readiness to address obesity using 18 questions from the Community Readiness Handbook. Means and standard deviations were evaluated and scores ranged from 1 (no readiness) to 9 (high readiness). We then assessed stakeholder attitudes regarding the feasibility of implementing specific strategies given tribal culture, infrastructure, leadership, and funding support. Average scores were calculated and mean values ranked from highest (best strategy) to lowest. Despite significant differences in their geographic and sociodemographic characteristics, both communities identified increasing the availability of healthy foods in tribal venues as the most feasible strategy and scored in the “preplanning” readiness stage. The survey design, implementation process, and findings generated significant community interest and discussion. Health planners in one of the communities used the survey findings to provide tribal decision-makers with measurable information to prioritize appropriate strategies for implementation

Health in All Policies: Working Across Sectors in Cooperative Extension to Promote Health for All

A Health in All Policies approach engages cross-sector stakeholders to collaboratively improve systems that drive population health. We, the members of the Extension Committee on Organization and Policy (ECOP)’s Health in All Policies Action Team, propose that adopting a Health in All Policies approach within the national Cooperative Extension System will better prepare us to contribute meaningfully to improving the nation’s health. We first explain the Health in All Policies approach and argue for why and how it is relevant for Extension. We then present insights gathered from Extension Family and Consumer Sciences program leaders and state specialists to assess whether national and state leadership are poised to adopt a Health in All Policies approach within their affiliated programs. Although participant leaders saw the value of the approach in contributing to population health improvement, they generally saw the Extension system as having lower levels of readiness to adopt such an approach. Six themes emerged as ways to increase Extension’s engagement in Health in All Policies: a paradigm shift within Extension, professional development of competencies, transformational leaders and leadership support, continued and new partnerships, information access for all levels and disciplines of Extension

Influencing proactive and reactive aggression: C-SELF The socio-emotional learning fortification program in Antigua and Barbuda

There are no structured programs to respond to youth violence amongst students in the Caribbean. There has been little data collected and organized research conducted on the efficacy and impact of programs which may combat youth violence. Without rigorous impact evaluations, the region continues to lack effective and sustaining strategies for preventive programs. This manuscript shares outcomes from the implementation of the Children and Youth Social-Emotional Learning Fortification (C-SELF) strategy embedded into the curriculum in five schools in Antigua and Barbuda. In 2020, using data from 2017 to 2018, a mixed method study was conducted with 482 (intervention) and 152 (control) primary school students. Data was analyzed for the influence of the intervention on 16 factors. The findings suggest positive outcomes, without significance, in self-control and competence. It demonstrates the importance of social-emotional learning curriculum changes to increase children’s mastery of self-regulated behaviors, decision-making, self-management, and self-leadership skills

Melting Himalayan Glaciers Threaten Domestic Water Resources in the Mount Everest Region, Nepal

Retreating glaciers and snowpack loss threaten high-altitude communities that rely upon seasonal melt for domestic water resources. But the extent to which such communities are vulnerable is not yet understood, largely because melt contribution to water supplies is rarely quantified at the catchment scale. The Khumbu Valley, Nepal is a highly glaciated catchment with elevations ranging from 2,000 to 8,848 m above sea level, where more than 80% of annual precipitation falls during the summer monsoon from June to September. Samples were collected from the rivers, tributaries, springs, and taps along the major trekking route between Lukla and Everest Base Camp in the pre-monsoon seasons of 2016–2017. Sources were chosen based upon their use by the communities for drinking, cooking, bathing, and washing, so the sample suite is representative of the local domestic water supply. In addition, meltwater samples were collected directly from the base of the Khumbu Glacier, and several rain samples were collected throughout the study site. Meltwater contribution was estimated from δ18O isotopic data using a two-component mixing model with the Khumbu glacial melt and pre-monsoon rain as endmembers. Results indicate between 34 and 90% of water comes from melt during the dry, pre-monsoon season, with an average meltwater contribution of 65%. With as much as two-thirds of the dry-season domestic water supply at risk, the communities of the Khumbu Valley are extremely vulnerable to the effects of climate change as glaciers retreat and snowpack declines

Winter 2015

Volume 2, Issue 1 Winter 2015Volumn 2, Issue 1 of the Journal of Teaching Effectiveness and student AcievementAngelo State University College of EducationInvestigating a Model of Mentoring for Effective Teaching Dr. Lori Bird and Dr. Peter Hudson…….p11 Early Career Teacher Attrition: Searching for Answers in Preservice Preparation Dr. Gloria Graham Flynn………p22 A Perceptual Assessment of Non-Traditional STEM Teacher Candidates: A University Partnership for Transition to Teaching Dr. Gail Hughes, Dr. Alicia Cotabish, Dr. Carolyn Williams, and Dr. Donna Wake…..p32 Baby It’s Cold Outside: Perspectives on Teacher Retention and Student Achievement in Artic Schools Dr. Ute Kaden………p45 Transformations to Serve English Learners: A Call for Innovative Partnerships in Educator Preparation Dr. Joan Lachance………p56 Successes and Struggles of Teaching: Perspectives of Beginning, Mid-Career, and Veteran Teachers Dr. Alyson Lavigne and Dr. Amanda Bozack………p68 Teacher Inquiry: A Foundation for Mentoring Teachers During Induction and Throughout Their Career Dr. Michele Marable, Dr. Kristin Kurtsworth--‐Keen, Dr. Kelly Harper, and Dr. Karen Dutt-Doner…….p81 Perceptions of Transformational Leadership Behavior by Secondary Principals and Teachers in Diverse and Non-Diverse Schools Dr. Fernando Valle and Dr. Gionet Cooper…..p9

Case identification of depression in patients with chronic physical health problems: a diagnostic accuracy meta-analysis of 113 studies.

Depression is more likely in patients with chronic physical illness, and is associated with increased rates of disability and mortality. Effective treatment of depression may reduce morbidity and mortality. The use of two stem questions for case finding in diabetes and coronary heart disease is advocated in the Quality and Outcomes Framework, and has become normalised into primary care

Chromosome-wide DNA methylation analysis predicts human tissue-specific X inactivation

X-chromosome inactivation (XCI) results in the differential marking of the active and inactive X with epigenetic modifications including DNA methylation. Consistent with the previous studies showing that CpG island-containing promoters of genes subject to XCI are approximately 50% methylated in females and unmethylated in males while genes which escape XCI are unmethylated in both sexes; our chromosome-wide (Methylated DNA ImmunoPrecipitation) and promoter-targeted methylation analyses (Illumina Infinium HumanMethylation27 array) showed the largest methylation difference (D = 0.12, p < 2.2 E−16) between male and female blood at X-linked CpG islands promoters. We used the methylation differences between males and females to predict XCI statuses in blood and found that 81% had the same XCI status as previously determined using expression data. Most genes (83%) showed the same XCI status across tissues (blood, fetal: muscle, kidney and nerual); however, the methylation of a subset of genes predicted different XCI statuses in different tissues. Using previously published expression data the effect of transcription on gene-body methylation was investigated and while X-linked introns of highly expressed genes were more methylated than the introns of lowly expressed genes, exonic methylation did not differ based on expression level. We conclude that the XCI status predicted using methylation of X-linked promoters with CpG islands was usually the same as determined by expression analysis and that 12% of X-linked genes examined show tissue-specific XCI whereby a gene has a different XCI status in at least one of the four tissues examined

Inactive X chromosome-specific reduction in placental DNA methylation

Genome-wide levels of DNA methylation vary between tissues, and compared with other tissues, the placenta has been reported to demonstrate a global decrease in methylation as well as decreased methylation of X-linked promoters. Methylation is one of many features that differentiate the active and inactive X, and it is well established that CpG island promoters on the inactive X are hypermethylated. We now report a detailed analysis of methylation at different regions across the X in male and female placenta and blood. A significant (P < 0.001) placental hypomethylation of LINE1 elements was observed in both males and females. Relative to blood placental promoter hypomethylation was only observed for X-linked, not autosomal promoters, and was significant for females (P < 0.0001) not males (P = 0.9266). In blood, X-linked CpG island promoters were shown to have moderate female methylation (66% across 70 assays) and low (23%) methylation in males. A similar methylation pattern in blood was observed for ∼20% of non-island promoters as well as 50% of the intergenic or intragenic CpG islands, the latter is likely due to the presence of unannotated promoters. Both intragenic and intergenic regions showed similarly high methylation levels in male and female blood (68 and 66%) while placental methylation of these regions was lower, particularly in females. Thus placental hypomethylation relative to blood is observed globally at repetitive elements as well as across the X. The decrease in X-linked placental methylation is consistently greater in females than males and implicates an inactive X specific loss of methylation in the placenta

Fifteen years of the Australian imaging, biomarkers and lifestyle (AIBL) study: Progress and observations from 2,359 older adults spanning the spectrum from cognitive normality to Alzheimer\u27s disease

Background: The Australian Imaging, Biomarkers and Lifestyle (AIBL) Study commenced in 2006 as a prospective study of 1,112 individuals (768 cognitively normal (CN), 133 with mild cognitive impairment (MCI), and 211 with Alzheimer\u27s disease dementia (AD)) as an \u27Inception cohort\u27 who underwent detailed ssessments every 18 months. Over the past decade, an additional 1247 subjects have been added as an \u27Enrichment cohort\u27 (as of 10 April 2019). Objective: Here we provide an overview of these Inception and Enrichment cohorts of more than 8,500 person-years of investigation. Methods: Participants underwent reassessment every 18 months including comprehensive cognitive testing, neuroimaging (magnetic resonance imaging, MRI; positron emission tomography, PET), biofluid biomarkers and lifestyle evaluations. Results: AIBL has made major contributions to the understanding of the natural history of AD, with cognitive and biological definitions of its three major stages: preclinical, prodromal and clinical. Early deployment of Aβ-amyloid and tau molecular PET imaging and the development of more sensitive and specific blood tests have facilitated the assessment of genetic and environmental factors which affect age at onset and rates of progression. Conclusion: This fifteen-year study provides a large database of highly characterized individuals with longitudinal cognitive, imaging and lifestyle data and biofluid collections, to aid in the development of interventions to delay onset, prevent or treat AD. Harmonization with similar large longitudinal cohort studies is underway to further these aims

The Australasian Resuscitation In Sepsis Evaluation : fluids or vasopressors in emergency department sepsis (ARISE FLUIDS), a multi-centre observational study describing current practice in Australia and New Zealand

Objectives: To describe haemodynamic resuscitation practices in ED patients with suspected sepsis and hypotension. Methods: This was a prospective, multicentre, observational study conducted in 70 hospitals in Australia and New Zealand between September 2018 and January 2019. Consecutive adults presenting to the ED during a 30-day period at each site, with suspected sepsis and hypotension (systolic blood pressure <100 mmHg) despite at least 1000 mL fluid resuscitation, were eligible. Data included baseline demographics, clinical and laboratory variables and intravenous fluid volume administered, vasopressor administration at baseline and 6- and 24-h post-enrolment, time to antimicrobial administration, intensive care admission, organ support and in-hospital mortality. Results: A total of 4477 patients were screened and 591 were included with a mean (standard deviation) age of 62 (19) years, Acute Physiology and Chronic Health Evaluation II score 15.2 (6.6) and a median (interquartile range) systolic blood pressure of 94 mmHg (87–100). Median time to first intravenous antimicrobials was 77 min (42–148). A vasopressor infusion was commenced within 24 h in 177 (30.2%) patients, with noradrenaline the most frequently used (n = 138, 78%). A median of 2000 mL (1500–3000) of intravenous fluids was administered prior to commencing vasopressors. The total volume of fluid administered from pre-enrolment to 24 h was 4200 mL (3000–5661), with a range from 1000 to 12 200 mL. Two hundred and eighteen patients (37.1%) were admitted to an intensive care unit. Overall in-hospital mortality was 6.2% (95% confidence interval 4.4–8.5%). Conclusion: Current resuscitation practice in patients with sepsis and hypotension varies widely and occupies the spectrum between a restricted volume/earlier vasopressor and liberal fluid/later vasopressor strategy